屋尘螨过敏原组分在过敏性疾病发病机制中作用的研究进展

文献信息

中文摘要

屋尘螨（HDM）是全球最常见的室内气传过敏原之一，与2型免疫介导的疾病密切相关，包括过敏性哮喘、过敏性鼻炎和特应性皮炎。迄今为止，已鉴定出30多种HDM过敏原组分，并根据其结构和生物学特征分为蛋白酶、脂质结合蛋白、结构蛋白和功能未表征的蛋白。其中，第1、2和23组过敏原表现出强大的免疫球蛋白E（IgE）结合活性，在过敏致敏和炎症级联反应中发挥关键作用。HDM过敏原破坏上皮屏障完整性，激活细胞表面受体，并通过Toll样受体促进树突状细胞成熟，从而驱动2型免疫反应。此外，近期研究表明，HDM过敏原通过影响代谢途径（如糖酵解、脂质代谢和铁死亡）来调节免疫微环境的稳态。传统诊断和治疗严重依赖粗制螨提取物，其局限性包括成分复杂、批间差异大以及不良反应风险高。相反，组分解析诊断（CRD）和过敏原免疫治疗（AIT）为精准医学提供了新途径。本综述系统阐述了HDM过敏原组分在过敏性疾病中的分类、结构特征和免疫致病机制，并进一步总结了精准诊断和靶向干预的最新进展，旨在为过敏性疾病的个体化临床管理提供理论基础。

英文摘要

House dust mites (HDMs) represent one of the most prevalent indoor aeroallergens globally and are closely associated with type 2 immune-mediated conditions, including allergic asthma, allergic rhinitis, and atopic dermatitis. To date, over 30 HDM allergenic components have been identified and are classified into proteases, lipid-binding proteins, structural proteins, and proteins with uncharacterized functions based on their structural and biological features. Among these, allergens from group 1, 2, and 23 exhibit robust immunoglobulin E(IgE)-binding activity and play pivotal roles in allergic sensitization and inflammatory cascades. HDM allergens disrupt epithelial barrier integrity, activate cell surface receptors, and promote the maturation of dendritic cells via Toll-like receptors, thereby driving type 2 immune responses. Furthermore, recent studies indicate that HDM allergens modulate the homeostasis of the immune microenvironment by affecting metabolic pathways, such as glycolysis, lipid metabolism, and ferroptosis. Traditional diagnostics and treatments heavily rely on crude mite extracts, which are limited by their complex composition, batch-to-batch variability, and a heightened risk of adverse reactions. Conversely, component-resolved diagnosis (CRD) and allergen immunotherapy (AIT) present novel avenues for precision medicine. This review systematically delineates the classification, structural characteristics, and immunopathogenic mechanisms of HDM allergen components in allergic diseases. It further summarizes recent advances in precision diagnostics and targeted interventions, aiming to provide a theoretical foundation for the individualized clinical management of allergic diseases.